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Additional information - A psychological talking therapy for suicidality in people experiencing non-affective psychosis: Mechanism and efficacy outcomes of the CARMS (Cognitive AppRoaches to coMbatting Suicidality) randomised controlled trial - NCBI Bookshelf An official website of the United States government Here's how you know The .gov means it's official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site. The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. 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Southampton (UK): National Institute for Health and Care Research; 2026 Mar. (Efficacy and Mechanism Evaluation, No. 13.03.) A psychological talking therapy for suicidality in people experiencing non-affective psychosis: Mechanism and efficacy outcomes of the CARMS (Cognitive AppRoaches to coMbatting Suicidality) randomised controlled trial. Show details Efficacy and Mechanism Evaluation, No. 13.03. Gooding P, Awenat Y, Drake R, et al. Southampton (UK): National Institute for Health and Care Research ; 2026 Mar. Contents Search term < Prev Next > Additional information CRediT contribution statement Patricia Gooding ( https://orcid.org/0000-0002-7458-4462 ) : Conceptualisation (lead), Funding acquisition (lead), Methodology (lead), Project administration (lead), Supervision (lead), Validation (has directly accessed and verified the underlying RCT , therapy process, SAE, and qualitative data), Writing – original draft (lead), Writing – reviewing and editing (lead). Yvonne Awenat ( https://orcid.org/0000-0002-0767-4994 ) : Conceptualisation (support), Funding acquisition (support), Methodology (support), Investigation (equal), Project administration (support), Supervision (lead), Writing – original draft (support), Writing – reviewing and editing (support). Richard Drake ( https://orcid.org/0000-0003-0220-4835 ) : Conceptualisation (support), Funding acquisition (support), Methodology (support), Investigation (responsible for diagnostic and psychiatric decisions), Supervision (support), Writing – original draft (support), Writing – reviewing and editing (support). Richard Emsley ( https://orcid.org/0000-0002-1218-675X ) : Conceptualisation (statistical lead), Validation (lead – has directly accessed and verified the underlying CARMS data), Data curation (lead), Formal analysis (lead as trial statistician), Visualisation (support), Writing – original draft (support), Writing – reviewing and editing (support). Steven Jones ( https://orcid.org/0000-0002-8801-5113 ) : Conceptualisation (support), Funding acquisition (support), Methodology (support), Investigation (acted as a trial therapist), Writing – original draft (support), Writing – reviewing and editing (support). Navneet Kapur ( https://orcid.org/0000-0002-3100-3234 ) : Conceptualisation (support), Funding acquisition (support), Methodology (support), Writing – original draft (support), Writing – reviewing and editing (support). Fiona Lobban ( https://orcid.org/0000-0001-6594-4350 ) : Conceptualisation (support), Funding acquisition (support), Methodology (support), Writing – original draft (support), Writing – reviewing and editing (support). Sarah Peters ( https://orcid.org/0000-0003-1949-3995 ) : Conceptualisation (qualitative lead), Funding acquisition (lead for qualitative workstreams), Methodology (lead for qualitative workstreams), Project administration (lead for qualitative workstreams), Supervision (lead qualitative research staff, mentoring), Validation (has directly accessed and verified the underlying qualitative data), Writing – original draft (qualitative sections – equal), Writing – reviewing and editing (qualitative sections – equal). Daniel Pratt ( https://orcid.org/0000-0001-8843-1224 ) : Conceptualisation (support), Funding acquisition (support), Methodology (support), Project administration (lead trial therapy processes, SAE decisions – support), Supervision (lead for trial therapists, lead clinical supervision of research staff), Validation (has directly accessed and verified the therapy process data), Writing – original draft (support), Writing – reviewing and editing (support). Rachel Elliot ( https://orcid.org/0000-0002-3650-0168 ) : Conceptualisation (lead for health economy workstream), Validation (lead – has directly accessed and verified the underlying data), Data curation (HE – support), Formal analysis (lead – HE data analysis), Visualisation (support HE data), Writing – original draft (support), Writing – reviewing and editing (support). Bradley Boardman ( https://orcid.org/0009-0000-7670-2728 ) : Project administration (lead as a Trial Manager), Data curation (support). Elizabeth Camacho ( https://orcid.org/0000-0001-9574-7710 ) : Validation (lead – has directly accessed and verified the underlying HE data), Data curation (HE – lead), Formal analysis (lead HE data analysis), Visualisation (lead HE data), Writing – original draft (support), Writing – reviewing and editing (support). Danielle Edwards ( https://orcid.org/0000-0001-7446-4324 ) : Validation (lead – has directly accessed and verified the underlying CARMS data), Data curation (lead), Formal analysis (equal), Visualisation of data (lead), Writing – original draft (support), Writing – reviewing and editing (support). Kamelia Harris ( https://orcid.org/0000-0003-2806-1262 ) : Project administration (lead as a Trial Manager), Data curation (equal), Writing – original draft (support), Writing – reviewing and editing (support). Charlotte Huggett ( https://orcid.org/0000-0002-7566-6224 ) : Project administration (lead as a Trial Manager), Data curation (equal), Investigation (support – conducted qualitative interviews), Writing – original draft (support), Writing – reviewing and editing (support). Gillian Haddock ( https://orcid.org/0000-0001-6234-5774 ) : Conceptualisation (lead), Funding acquisition (lead), Methodology (lead), Project administration (lead), Supervision (lead supervision of research staff and mentoring; colead trial therapist supervision), Validation (has directly accessed and verified the therapy process data), Writing – original draft (equal), Writing – reviewing and editing (lead). Other contributions Patricia Gooding: qualitative analysis and interpretation (equal) Yvonne Awenat: qualitative analysis and interpretation (support) Richard Drake: psychiatrist lead Steven Jones: clinical implications Navneet Kapur: clinical implications from perspective of psychiatrist and epidemiologist Fiona Lobban: clinical implications Sarah Peters: qualitative analysis and interpretation (lead) Daniel Pratt: clinical interpretation (equal) Kamelia Harris: qualitative analysis and interpretation (equal) Gillian Haddock: clinical interpretation (lead) Acknowledgements CARMers: we very much appreciate the consistently insightful input from members of our Service User Reference Group (known as the CARMers) who have assisted with numerous and important aspects of CARMS from the inception of the CARMS project in 2014. Participants: we would like to sincerely thank all those individuals who were participants in the CARMS project and to convey our appreciation of the time and the immense effort given to CARMS . CARMS TSC and DMEC : we would like to sincerely thank the TSC Chair, Thomas Craig, the DMEC Chair, David Kingdon and all the committee members (Michelle Collinson; Kate Davidson; Caroline Hellewell; Joe Keaney; Elizabeth Kuipers; Nicky Lidbetter; Elizabeth Kuipers; William Sellwood) for their unrelenting support throughout the lifecycle of the CARMS project. CARMS trial therapists and RAs: CARMS could not have happened without the enthusiastic and consistent dedication from the RAs and trial therapists working on the CARMS project. NHS colleagues: many professionals across NHS Trusts and third sector organisations have actively supported and contributed to the CARMS project in ways that are pivotal which we would like to acknowledge. Our special thanks and appreciation go to Sarah Leo and Susan Dobson in GMMH . Academic colleagues: academic colleagues who were not grant holders helped CARMS in many ways, including advising on aspects of structured clinical interviews and clinical skills training. Sponsor The CARMS sponsor was Manchester University, UK. Host The CARMS host was Greater Manchester Mental Health NHS Foundation Trust. CONSORT standards The design of CARMS followed CONSORT 70 and SPIRIT guidelines, 71 and the TIDieR checklist and guide. 72 Final trial protocol: version and publication The most current version of the CARMS protocol is version 6.0 available from the corresponding author. The trial protocol has been published. 65 Patient data statement Participant data routinely collected by the NHS was not analysed as outcome variables by the CARMS project. However, we did have access to information contained in clinical notes which we could add to as necessary (e.g. risk information). Data-sharing statement The raw data sets generated and analysed during the current study are not publicly available as participants did not provide consent for this. De-identified data are available from the corresponding author upon reasonable request. Ethics statement Ethics approval and consent to participate: the current study was approved by a NHS Research Ethics Committee (reference: 17/NW/0089). Date of favourable opinion - 21 March 2017. Relevant ethical and legal guidelines concerning confidentiality and the storage of personal data were followed (e.g. General Data Protection Regulation). Signed informed consent forms by participants and countersigned by CARMS team staff were stored on NHS and/or University secure servers/drives separate to the research data. Consent for publication: participants provided signed informed consent for quotes to be used for publications. All coauthors have read the manuscript and provided consent for this manuscript to be published. Trial Steering Committee and Data Management: members of the CARMS TSC (Chair Thomas Craig) and DMEC (Chair David Kingdon) have provided guidance on all aspects of CARMS since 2017, including during the COVID-19 pandemic. Information governance statement Manchester University is committed to handling all personal information in line with the UK Data Protection Act (2018) and the General Data Protection Regulation (EU GDPR) 2016/679. Under the Data Protection legislation, Manchester University is the Data Controller. More information about how the University handles personal data, including how to exercise individual rights and the contact details for the Data Protection Officer here: www.manchester.ac.uk/about/privacy-information/data-protection/ . Disclosure of interests Full disclosure of interests: Completed ICMJE forms for all authors, including all related interests, are available in the toolkit on the NIHR Journals Library report publication page at https://doi.org/10.3310/GJPG0530 . Primary conflicts of interest: Patricia Gooding has received funds from University of Manchester (UoM), Division of Psychology and Mental Health, Research and Teaching Fund, to attend conferences (travel and fees paid direct to organiser from UoM) to present CARMS project work, the last being ESSSB, Rome, September 2024. Richard Drake has received grant funding as follows: antidepressant for the prevention of DEPression following first episode Psychosis (ADEPP), NIHR127700 127700; GOTHIC2: A multi-centre randomised placebo-controlled trial of glycopyrrolate and hyoscine hydrobromide for the treatment of clozapine-induced hypersalivation NIHR 131157; CONNECT Digital markers to Predict Psychosis, Wellcome Trust, reference 120160; The Mental Imagery for Suicidality in Students Trial (MISST) NIHR 203468; ATLANTIS: AnTiconvuLsant AugmeNtation Trial In Schizophrenia. National Institute for Health Research NIHR127755; The Effect on Relapse of Culturally-Adapted Family Intervention (CaFI) Compared to Usual Care Among African and Carribean People Diagnosed with Psychosis in the UK, NIHR HTA 16/167/76; CLEAR: (CLozapine in EARly psychosis) A Multi-Centre, Randomised Controlled trial of Clozapine for Young People with Treatment Resistant Psychosis in Real World Settings, NIHR131175; GOTHIC2: A multi-centre randomised placebo-controlled trial of glycopyrrolate and hyoscine hydrobromide for the treatment of clozapine-induced hypersalivation, NIHR 131157. Richard Drake is supported by the NIHR Manchester Biomedical Research Centre (NIHR203308), Manchester University. Richard Emsley is supported by an NIHR Research Professorship (NIHR300051) and the NIHR Maudsley Biomedical Research Centre, part of the NIHR and hosted by South London and Maudsley NHS Foundation Trust in partnership with King’s College London. RE was a member of the NIHR CTU Standing Advisory Committee From 1 January 2020 to 1 January 2024 and the HTA Clinical Evaluation and Trials Committee from 1 November 2017 to 30 November 2021. Rachel Elliott has received grant funding as follows: NIHR HTA programme NIHR131159 Monitoring and follow-up for adults with hearing loss; Follow-up and structured monitoring for adults offered a NHS hearing aid for the first time (FAMOUS); NIHR PRC refunding call, NIHR204295; NIHR RfPB NIHR203515 Relational Approach to Treating Self-Harm (RelATe); NIHR RfPB NIHR203560 Parenting Intervention for Parents with Psychosis in Adult Mental Health Services (PIPPA); NIHR Research Support Service NIHR205421; NIHR HTA NIHR158471 The clinical and cost effectiveness of oraL versus intrAmuscular glucocorticoiDs in rhEumatoid aRthritis (LEADER); NIHR HTA NIHR158678 CLArithromycin for Stroke associated Pneumonia (CLASP); NIHR HSDR NIHR160217 Mixed-methods impact and implementation evaluation of the Pharmacy First Services for management of common conditions; NIHR HSDR NIHR160668. Using patient-led appointment scheduling to improve cost-effectiveness, access, and patient satisfaction in NHS Talking Therapies; NIHR PDG NIHR208327 Enabling local and national decision-makers to use economic evaluation to support decisions around implementing medication safety initiative; Diabetes UK Reference 18/0005836. Rachel Elliott has sat on NICE technology appraisal committee 2006–23; acted as NIHR ACAF panel chair 2006–23; and is a Pharmacy Research UK Trustee 2022–current date of submission, 2025. Navneet Kapur has received research grants to undertake work in suicide prevention and self-harm research awarded to institution from DHSC, Medical Research Council (MRC)/NIHR (EME 13/161/25), Healthcare Quality Improvement Partnership NIHR204295. Navneet Kapur has been an unpaid committee member for guideline groups for NICE , advisory group member for DHSC 2002 – to date, i.e. current at time of submission, 2025. Navneet Kapur is supported by the NIHR Manchester Biomedical Research Centre (NIHR203308), Manchester University. Elizabeth Camacho was a member of the HTA Clinical Evaluation and Trials Committee 1 December 2020–31 March 2025. Kamelia Harris received an Early Career Award for the Schizophrenia International Research Society from University of Manchester Divisional Funding. Gillian Haddock was supported by an NIHR senior investigator award NIHR201393 (2020–4). Gillian Haddock is supported by the NIHR Manchester Biomedical Research Centre (NIHR203308), Manchester University. Gillian Haddock has received funding from: WELLCOME Trust Flagship psychosis grant, CONNECT, reference 222875/Z/21/Z, 2022–7, 2019–31 October 2023; Wellcome Innovations Project award, Optimising AVATAR therapy for distressing voices: a multi-centre RCT (AVATAR) 2019–23, reference 215471/Z/19/Z; NIHR programme grant awards: NIHR The Prevention of Suicide Behaviour In Prison. Enhancing Access to Therapy (PROSPECT) reference RP-PG-0218-20006; NIHR Improving access to psychological therapy on acute mental health wards (TULIPS), reference RP-PG-0216-20009. Gillian Haddock receives royalties from Haddock G, Slade PD, editors. Cognitive-behavioural Approaches in the Treatment of Psychotic Disorders . London: Routledge; 1996; Tarrier N, Wells A, Haddock G, editors. Complex Cases in Cognitive-behaviour Therapy . Chichester: Wiley; 1998 and Palmier-Claus J, Varese F, Haddock G. A Guide to Experience Sampling in Mental Health . London: Taylor and Francis; 2018. She has received funded expenses and a small honorarium for World Association for Cognitive and Behavioural Psychotherapies, Seoul, South Korea 2023 – Workshop and keynote address entitled ‘Working with complex issues in psychosis: suicidality, violence and substance misuse’; BABCP Annual Conference, Bath. 2019; Icelandic Association for Cognitive behaviour Therapy, Reykavik, Iceland – keynote address entitled Cognitive behaviour therapy for psychosis 2019; and been funded for various conferences from University of Manchester. Gill Haddock served on the NIHR PGFAR Committee, 2017–9. Gill Haddock is involved with a collaboration with Manchester Innovation Factory for commercialisation of ACTISSIST software (5%). No other coauthor reported any disclosures of interest. Copyright and credit statement Every effort has been made to obtain the necessary permissions for reproduction, to credit original sources appropriately and to respect copyright requirements. However, despite our diligence, we acknowledge the possibility of unintentional omissions or errors and we welcome notifications of any concerns regarding copyright or permissions. Publications Academic publications Gooding PA, Pratt D, Awenat Y, Drake R, Elliott R, Emsley R, et al . A psychological intervention for suicide applied to non-affective psychosis: the CARMS (Cognitive AppRoaches to coMbatting Suicidality) randomised controlled trial protocol. BMC Psychiatry 2020; 20 :306. https://doi.org/10.1186/s12888-020-02697-8 Huggett C, Gooding P, Haddock G, Pratt D. The Relationship between the Therapeutic Alliance and Suicidal Experiences in People with Psychosis Receiving Therapy. Int J Environ Res Public Health 2021; 18 :10706. https://doi.org/10.3390/ijerph182010706 Peters S, Cook L, Littlewood D, Awenat Y, Drake R, Gill J, et al . A systematic investigation of the short and long term experiences of taking part in research about suicidal thoughts and acts in the context of a randomised controlled trial. SSM Mental Health 2022; 2 :100157. https://doi.org/10.1016/j.ssmmh.2022.100157 Gooding P, Haddock G, Harris K, Asriah M, Awenat Y, Cook L, et al . The interplay between suicidal experiences, psychotic experiences and interpersonal relationships: a qualitative study. BMC Psychiatry 2023; 23 :873. https://doi.org/10.1186/s12888-023-05164-2 Harris K, Gooding P, Awenat Y, Haddock G, Cook L, Huggett C, et al . Acceptability of a novel suicide prevention psychological therapy for people who experience non-affective psychosis. Psychol Psychother 2023; 96: 560–76. https://doi.org/10.1111/papt.12456 Peters S, Awenat Y, Gooding PA, Harris K, Cook L, Huggett C, et al . What is important to service users and staff when implementing suicide-focused psychological therapies for people with psychosis into mental health services? Front Psychiatry 2023; 14 :1154092. https://doi.org/10.3389/fpsyt.2023.1154092 Berry N, Peters S, Haddock G, Scott A, Harris K, Cook L, et al . How individuals with psychosis develop and maintain resilience to suicidal experiences through psychological therapy: a qualitative study. BMC Psychiatry 2024; 24 :874. https://doi.org/10.1186/s12888-024-06071-w Gooding P, Harris K, Duxbury P, Pratt D, Huggett C, Emsley R, et al . Influence of perceived harm due to substance use on the relationships between positive psychotic experiences and suicidal experiences in people with non-affective psychosis. Psychol Med 2024; 54 :1–11. https://doi.org/10.1017/s0033291724001764 Gooding P, Pratt D, Edwards D, Awenat Y, Drake RJ, Emsley R, et al . Underlying mechanisms and efficacy of a suicide-focused psychological intervention for psychosis, the Cognitive Approaches to Combatting Suicidality (CARMS): a multicentre, assessor-masked, randomised controlled trial in the UK. Lancet Psychiatry 2025; 12 :177–88. https://doi.org/10.1016/S2215-0366(24)00399-7 Conference symposia, talks, posters, workshops, seminars and webinars 2025 CARMS symposium: Gooding PA, Haddock G, Harris K, Fitzsimmons M. A Theoretically-grounded, Evidence-based, Suicide-focused Therapy: What Is It, and How Does It Work for People Living with Psychotic Experiences? European Association for Behavioural and Cognitive Therapies (EABCT), Glasgow, UK, September 2025. CARMS showcase conference: Gooding PA, Haddock G; The CARMS Team. A Showcase to Highlight Advances in Psychological Approaches to Developing Interventions for People Living with Psychotic and Suicidal Experiences: What Have We Learned from Recent Work and Where Do We Go Now? Manchester University, Manchester, UK; May 2025. Webinar: Gooding PA. Understanding the Psychology of Suicide and Resilience to Suicide: The CARMS Project . Self Help and The Big Life Group, Manchester, UK, April 2025. Conference presentation: Gooding PA. CARMS (Cognitive AppRoaches to coMbatting Suicidality): Key Findings . Suicide Risk and Safety Research Unit conference, Manchester, UK, January 2025. 2024 CARMS symposium: Gooding PA [convenor], Haddock G, Harris K, Mulligan L. People Who Live with Psychosis: From Suicide-theory to Suicide-therapy in Some of the Most Vulnerable . European Symposium on Suicide and Suicidal Behaviour (ESSSB), Rome, Italy, August 2024. CARMS symposium: Harris K [convenor], Haddock G, Gooding PA, Pratt D, Berry N. Pathways Underlying Suicidal Experiences and the Effect of a Suicide-focused Therapy for People with Psychosis and Male Prisoners . British Association for Behavioural and Cognitive Psychotherapies (BABCP), Manchester, UK, July 2024. Conference presentation: Gooding PA. CARMS (Cognitive AppRoaches to coMbatting Suicidality): Initial Findings . Pennine Care NHS Foundation Trust, Research and Innovation Conference, Manchester, UK, May 2024. Conference presentation: Haddock G. The Interplay Between Suicide and Psychosis: Implications for Cognitive Behaviour Therapy for Psychosis . European Association for Behavioural and Cognitive Therapy (EABCT), Belgrade, Serbia, September 2024. 2023 CARMS symposium: Harris K [convenor], Haddock G, Gooding PA, Howarth Z. Mechanisms Underlying Suicidal Experiences and the Effect of a Suicide-focused Cognitive Therapy for People with Psychosis: CARMS* (Cognitive AppRoaches to coMbatting Suicidality) . British Association for Behavioural and Cognitive Psychotherapies (BABCP), Cardiff, UK, July 2023. CARMS poster: Boardman B, Gooding PA, Haddock G, Harris K. The Reasons Why People Experiencing Psychosis were Lost from Recruitment during a Randomised Controlled Trial That Investigated Pathways to Suicidality and a Suicide-focused Psychological Intervention . British Association for Behavioural and Cognitive Psychotherapies (BABCP), Cardiff, UK, July 2023. Conference presentation: Haddock G, Boardman B; the CARMS Team. Talking about Suicide and Psychosis: Key Issues in Therapy Delivery and Acceptability within the CARMS Trial . Lancashire and South Cumbria NHS Trust, Research and Innovation Conference, UK, February 2023. Keynote address: Haddock G. Tackling Suicide in People with Psychosis – We All Need to Talk about I t . World Congress of Cognitive and Behavioral Therapies (WCCBT), Seoul, South Korea, June 2023. Workshop: Haddock G. Psychological Treatment of Complex Cases of Psychosis . World Congress of Cognitive and Behavioral Therapies (WCCBT), Seoul, South Korea, June 2023. Conference presentation: Gooding PA. CARMS , Cognitive AppRoaches to coMbatting Suicidality: Initial Findings . Suicide Risk and Safety Research Unit Conference, Preston, UK, September 2023. 2022 Conference presentation: Haddock G, Harris K, Thomas Y, Howarth Z. Talking about Suicide and Psychosis: Key Issues in Therapy Delivery and Acceptability . 50th British Association for Behavioural and Cognitive Psychotherapies (BABCP) Conference, London, UK, July 2022. Conference presentation: Harris K. The Short- and Long-term Experiences of Taking Part in CARMS (Cognitive AppRoaches to coMbatting Suicidality) . Greater Manchester Mental Health, Research and Innovation Knowledge and Skills Development Day, Manchester, UK, November 2022. Conference presentation: Harris K. Acceptability of Suicide Prevention Therapy for People Who Experience Non-affective Psychosis . Suicide Risk and Safety Research Unit conference, Manchester, UK, April 2022. Continuing professional development workshop: Harris K. Acceptability of Suicide Prevention Therapy for People Who Experience Non-affective Psychosis . Greater Manchester Mental Health Trust, Manchester, UK, September 2022. 2021 Conference presentation (virtual): Peters S, Awenat Y, Pratt D, Gooding P, Haddock G. Mental Health Staff and Patients’ Perceptions of the Risks and Therapeutic Potential of Talking about Suicide . 19th International Conference on Communication in Healthcare, April 2021 (Virtual). 2020 CARMS seminar (virtual): Haddock G, Awenat Y, Pratt D. Understanding and Treating Suicidality: Pre and during COVID-19 . Manchester Academic Health Science Centre (MAHSC) Seminar Series, December 2020 (Virtual). 2019 Keynote address: Haddock G. Talking about Suicide Affects Us All . 47th British Association for Behavioural and Cognitive Psychotherapies (BABCP) conference, Bath, UK, September 2019. CARMS workshop: Haddock G. Delivering Psychological Interventions for People with Psychosis: Dealing with the Complexities of Suicidality and Risk within the Context of Delivering CBT for Psychosis . 47th British Association for Behavioural and Cognitive Psychotherapies (BABCP) Conference, Bath, UK, September 2019. CARMS symposium: Haddock G, Gooding PA, Awenat Y, Peters S. Developing Theoretically Driven Suicide-focused Psychological Treatments for Vulnerable Populations across Treatment Settings . 30th World Congress of the International Association for Suicide Prevention (IASP), Derry, Londonderry, UK, September 2019. CARMS poster: Littlewood D, Gooding PA, Peters S. What Is It Like to Take Part in Research about Your Suicidal Experiences? A Longitudinal Analysis of Individuals with Psychosis . 30th World Congress of the International Association for Suicide Prevention (IASP), Derry, Londonderry, UK, September 2019. CARMS poster: Cook L. What Is It Like to Take Part in Research about Suicidal Experiences? A Longitudinal Analysis of Individuals with Psychosis . Fourth Suicide and Self-harm Early and Mid-Career Researchers’ Forum, Glasgow, UK, June 2019. Conference presentation: Pratt D. An overview of the CARMS trial presented at the Patient Safety Research Unit (PSRU) conference to mark 1 year since the unit launch (Manchester, UK, 2019). 2018 Conference presentation: Pratt D, Awenat Y, Drake R, Emsley R, Haddock G, Jones S, et al . The Components of a Talking Therapy Designed to Explicitly Target Suicidal Thoughts and Acts: Cognitive AppRoaches to coMbatting Suicidality (CARMS) . 46th British Association for Behavioural and Cognitive Psychotherapies (BABCP) Conference, Glasgow, UK, July 2018. Conference presentation: Gooding PA. The Components of a Talking Therapy Designed to Explicitly Target Suicidal Thoughts and Acts: Cognitive AppRoaches to coMbatting Suicidality (CARMS) . European Symposium on Suicide and Suicidal Behaviour (ESSSB), Ghent, Belgium, September 2018. Continuing professional development workshop: Gooding PA, Earnshaw P. CARMS (Cognitive AppRoaches to coMbatting Suicidality): Suicidal Thoughts, Plans and Acts . Greater Manchester Mental Health Trust, Manchester, UK, September 2018. Disclaimers This report presents independent research. The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, the MRC, the EME programme or the Department of Health and Social Care. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, the EME programme or the Department of Health and Social Care. Copyright © 2026 Gooding et al . This work was produced by Gooding et al . under the terms of a commissioning contract issued by the Secretary of State for Health and Social Care. This is an Open Access publication distributed under the terms of the Creative Commons Attribution CC BY 4.0 licence, which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. See: https://creativecommons.org/licenses/by/4.0/ . For attribution the title, original author(s), the publication source – NIHR Journals Library, and the DOI of the publication must be cited. Bookshelf ID: NBK621215 Contents < Prev Next > Share Views PubReader Print View Cite this Page Gooding P, Awenat Y, Drake R, et al. A psychological talking therapy for suicidality in people experiencing non-affective psychosis: Mechanism and efficacy outcomes of the CARMS (Cognitive AppRoaches to coMbatting Suicidality) randomised controlled trial. Southampton (UK): National Institute for Health and Care Research; 2026 Mar. (Efficacy and Mechanism Evaluation, No. 13.03.) Additional information. 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